Health outcomes associated with crack-cocaine use: Systematic review and meta-analyses

Butler, Ainslie; Rehm, Jürgen; Fischer, Benedikt

doi:10.1016/j.drugalcdep.2017.08.036

Cited by 133 publications

(91 citation statements)

References 284 publications

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“…Indeed, given the well‐known synergistic effects of alcohol and HCV on liver disease progression, there is a strong rationale to treat and cure HCV infection among individuals with heavy alcohol use to decrease liver‐related morbidity and mortality, as well as healthcare‐related costs . Likewise, while data on the effects of crack on liver disease is limited and inconclusive, given the higher risk of HCV infection among this population, achieving and sustaining SVR may prevent onward HCV transmission . Accordingly, efforts are needed to facilitate and ensure equitable access to DAAs for substance using populations and optimize the individual and public‐health benefits of these treatments.…”

Section: Discussionmentioning

confidence: 99%

Disparities in uptake of direct‐acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting

Socías

Wood

et al. 2019

Liver International

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Background & Aims: Despite the high burden of hepatitis C virus (HCV) infection among people who inject drugs (PWID), uptake of interferon-based therapies has been extremely low. Increasing availability of direct-acting antiviral (DAA)-based therapies offers the possibility of rapid treatment expansion with the goal of controlling the HCV epidemic. We evaluated DAA-based treatment uptake among HCVpositive PWID in Vancouver after introduction of DAAs in the government drug formulary. Methods: Using data from three cohorts of PWID in Vancouver, Canada, we investigated factors associated with DAA-therapies uptake among participants with HCV Results: Of the 915 HCV-positive PWID, 611 (66.8%) were recent PWID and 369 (40.3%) had HIV coinfection. During the study period, 146 (16.0%) initiated DAA-therapies, a rate of 6.0 per 100 person-year, with higher initiation rates among non-recent PWID and an increasing trend over time. In multivariable analysis, HIV coinfection (Adjusted Odds Ratio [AOR] = 2.29, 95% Confidence Interval [CI]: 1.55-3.40), white race (AOR = 1.56, 95% CI: 1.05-2.35), and engagement in HCV care (AOR = 1.94, 95%CI: 1.31-2.90) were positively associated with DAA-therapies uptake, while high-risk drinking (AOR = 0.47, 95% CI: 0.23-0.88) and daily crack use were negatively associated (AOR = 0.41, 95% CI: 0.17-0.85). Among recent PWID, engagement in opioid agonist therapy emerged as an independent correlate of DAA uptake. Conclusions:Despite increases in HCV treatment uptake among PWID after the introduction of DAAs in our setting, disparities in access remain. Social-structural and behavioural barriers to HCV care should be addressed for the success of any HCV elimination strategy.

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Section: Discussionmentioning

confidence: 99%

Disparities in uptake of direct‐acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting

Socías

Wood

et al. 2019

Liver International

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“…Recreational COC consumption can result in several kinds of short-and long-term health damage, as well as psychological and physical dependence, and addiction. For example, exhaustion, somnolence, irritability, and judgment impairment are typical short-term effects, while stroke or ictus, paranoid psychosis and mucosal necrosis can appear over the long term [3,4]. For these reasons, COC is included in the lists of controlled substances of most States [5,6].…”

Section: Introductionmentioning

confidence: 99%

Blood and Plasma Volumetric Absorptive Microsampling (VAMS) Coupled to LC-MS/MS for the Forensic Assessment of Cocaine Consumption

2020

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Reliable, feasible analytical methods are needed for forensic and anti-doping testing of cocaine and its most important metabolites, benzoylecgonine, ecgonine methyl ester, and cocaethylene (the active metabolite formed in the presence of ethanol). An innovative workflow is presented here, using minute amounts of dried blood or plasma obtained by volumetric absorptive microsampling (VAMS), followed by miniaturized pretreatment by dispersive pipette extraction (DPX) and LC-MS/MS analysis. After sampling 20 µL of blood or plasma with a VAMS device, the sample was dried, extracted, and loaded onto a DPX tip. The DPX pretreatment lasted less than one minute and after elution with methanol the sample was directly injected into the LC-MS/MS system. The chromatographic analysis was carried out on a C8 column, using a mobile phase containing aqueous formic acid and acetonitrile. Good extraction yield (> 85%), precision (relative standard deviation, RSD < 6.0%) and matrix effect (< 12%) values were obtained. Analyte stability was outstanding (recovery > 85% after 2 months at room temperature). The method was successfully applied to real blood and plasma VAMS, with results in very good agreement with those of fluid samples. The method seems suitable for the monitoring of concomitant cocaine and ethanol use by means of plasma or blood VAMS testing.

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“…Keywords: Qualitative study, Palliative care, End-of-life, Terminal care, Substance use disorder, Addiction, Healthcare professionals Background People with a substance use disorder (SUD) are likely to develop more chronic and life-threatening conditions and die earlier than the general population [1][2][3][4][5][6][7]. Although most people with SUD recover, others may suffer from relapse or have lifelong addiction problems [8,9].…”

Section: (Continued From Previous Page)mentioning

confidence: 99%

Palliative care for patients with substance use disorder and multiple problems: a qualitative study on experiences of healthcare professionals, volunteers and experts-by-experience

et al. 2020

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Background: There is little information about how healthcare professionals feel about providing palliative care for patients with a substance use disorder (SUD). Therefore, this study aims to explore: 1) the problems and needs experienced by healthcare professionals, volunteers and experts-by-experience (HCP/VE) during their work with patients with SUD in a palliative care trajectory and; 2) to make suggestions for improvements using the quality of care model by Donabedian (Structure, Process, Outcome).Methods: A qualitative study was conducted, consisting of six focus group interviews which consisted of HCP/VE working with patients with SUD in a palliative care phase. At the end of the focus group interviews, participants structured and summarized their experiences within a Strengths, Weaknesses, Opportunities and Threats (SWOT) framework. Interview transcripts (other than the SWOT) were analysed by the researchers following procedures from the Grounded Theory Approach ('Grounded Theory Lite'). SWOT-findings were not subjected to in-depth analysis.Results: HCP/VE stated that within the Structure of care, care networks are fragmented and HCP/VE often lack knowledge about patients' multiplicity of problems and the time to unravel these. Communication with this patient group appears limited. The actual care-giving Process requires HCP/VE a lot of creativity and time spent seeking for cooperation with other caregivers and appropriate care settings. The latter is often hindered by stigma. Since no formalized knowledge is available, care-delivery is often exclusively experience-based. Pain-medication is often ineffective due to active substance use. Finally, several Outcomes were brought forward: Firstly, a palliative care phase is often identified only at a late stage. Secondly, education and a (mobile) team of expertise are desired. Thirdly, care for the caregivers themselves is often de-prioritized.

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Health outcomes associated with crack-cocaine use: Systematic review and meta-analyses

Cited by 133 publications

References 284 publications

Disparities in uptake of direct‐acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting

Disparities in uptake of direct‐acting antiviral therapy for hepatitis C among people who inject drugs in a Canadian setting

Blood and Plasma Volumetric Absorptive Microsampling (VAMS) Coupled to LC-MS/MS for the Forensic Assessment of Cocaine Consumption

Palliative care for patients with substance use disorder and multiple problems: a qualitative study on experiences of healthcare professionals, volunteers and experts-by-experience

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